NCT01072175 · CITED IN SOURCE DOCUMENTS
Investigate Safety, Pharmacokinetics and Pharmacodynamics of GSK2118436 & GSK1120212
An NCI or FDA source cites this study. A citation does not establish that it applies to an individual diagnosis.
- Phase
- PHASE2
- Status at capture
- COMPLETED
- Registry last update
- 2019-07-05
This was an open-label, dose escalation study to investigate the safety, pharmacokinetics, pharmacodynamics and clinical activity of GSK2118436 and GSK1120212 in combination. This study was designed in four parts. In Part A, the effect of repeat doses of GSK1120212 on the pharmacokinetics of single dose GSK2118436 was investigated prior to evaluating combination regimens. In Part B, the range of tolerated dose combinations was identified using a dose-escalation procedure. In Part C, different dose combinations of GSK2118436 and GSK1120212 were evaluated, based on results from the dose escalation cohorts. In Part D, the pharmacokinetics and safety of GSK2118436 administered as HPMC capsules alone and in combination with GSK1120212 was evaluated.
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What did the study report?
Outcomes, safety and baseline populations are separate source sections. Quality-of-life measures appear under their original outcome titles.
Participant flow
Baseline characteristics
Part A: Maximum Plasma Concentration (Cmax) of a Single Dose of Dabrafenib Administered Alone and in Combination With Trametnib
Part A: AUC (0-t) and AUC (0-inf) of Dabrafenib and Its Metabolites
Part B: Number of Participants With Any Adverse Event (AE) or Serious Adverse Event (SAE)
Part B: Number of Participants With Worst-case Chemistry Toxicity Grade Change From Baseline
Part B: Number of Participants With Worst-case Chemistry Change From Baseline With Respect to Normal Range
Part B: Number of Participants With Worst-case Hematology Toxicity Grade Change From Baseline
Part B: Number of Participants With Worst-case Hematology Change From Baseline With Respect to Normal Range
Part B: Number of Participants With the Indicated Worst-case Change From Baseline in Heart Rate and Blood Pressure
Part C (Randomized): Number of Participants With BRAF Mutant Metastatic Melanoma With Best Overall Response as Assessed by the Investigator
Part C (Randomized): Number of Participants With BRAF Mutant Metastatic Melanoma With Best Overall Response Assessed by Blinded Independent Central Review (BICR)
Part C (Crossover): Number of Participants With BRAF Mutant Metastatic Melanoma With Best Overall Response as Assessed by the Investigator
Part C (Randomized): Progression-free Survival (PFS) as Assessed by the Investigator
Part C (Crossover): Progression-free Survival (PFS) as Assessed by the Investigator
Part C (Randomized): Progression-free Survival (PFS) as Assessed by the Blinded Independent Central Review (BICR)
Part C (Randomized): Duration of Response as Assessed by the Investigator and Blinded Independent Central Review (BICR)
Part C (Randomized): Number of Participants With Any Adverse Event (AE) or Serious Adverse Event (SAE)
Part C (Randomized): Number of Participants With Worst-case Chemistry Toxicity Grade Change From Baseline
Part C (Randomized): Number of Participants With Worst-case Chemistry Change From Baseline With Respect to Normal Range
Part C (Randomized): Number of Participants With Worst-case Hematology Toxicity Grade Change From Baseline
Part C (Randomized): Number of Participants With Worst-case Hematology Change From Baseline With Respect to Normal Range
Part C (Randomized): Number of Participants With the Indicated Worst-case Change From Baseline in Heart Rate and Blood Pressure
Part D (Analyte=GSK2118436): Maximum Plasma Concentration (Cmax) of a Single and Repeat Dose of Dabrafenib Alone and in Combination With Trametinib
Part D (Analyte=GSK2118436): Tmax of a Single and Repeat Dose of Dabrafenib Alone and in Combination With Trametinib
Part D (Analyte=GSK2118436): AUC (0-tau) and AUC (0-inf) of Single and Repeat Doses of Dabrafenib Alone and in Combination With Trametinib
Part D: Number of Participants With Any Adverse Event (AE) or Serious Adverse Event (SAE)
Part D: Number of Participants With Worst-case Chemistry Toxicity Grade Change From Baseline
Part D: Number of Participants With Worst-case Chemistry Change From Baseline With Respect to Normal Range
Part D: Number of Participants With Worst-case Hematology Toxicity Grade Change From Baseline
Part D: Number of Participants With Worst-case Hematology Change From Baseline With Respect to Normal Range
Part D: Number of Participants With the Indicated Worst-case Change From Baseline in Heart Rate and Blood Pressure
Part A: Steady State Concentration of Trametinib With Concomitant Administration of Dabrafenib
Part B: AUC [0-tau] of Dabrafenib (DAB) and Its Metabolite in Combination With Trametinib
Part B: Pre-dose (Trough) Concentration at the End of the Dosing Interval (Ctau) and Maximum Plasma Concentration (Cmax) of Dabrafenib and Its Metabolite in Combination With Trametinib
Part B: Tmax of Dabrafenib and Its Metabolite in Combination With Trametinib
Part B (Analyte=GSK1120212): AUC (0-tau) Assessment of Trametinib in Combination With Dabrafenib
Part B (Analyte=GSK1120212): Ctau and Cmax Assessments of Trametinib in Combination With Dabrafenib
Part B (Analyte=GSK1120212): Tmax Assessment of Trametinib in Combination With Dabrafenib
Part B: Number of Participants With BRAFi-naïve Mutant Metastatic Melanoma With the Best Overall Response as Assessed by Investigator
Part B: Duration of Response as Assessed by the Investigator in Participants With BRAFi-naïve Mutant Metastatic Melanoma
Part B: Progression-free Survival (PFS) as Assessed by the Investigator in Participants With BRAFi-naïve Mutant Metastatic Melanoma
Part B: Overall Survival (OS) in BRAFi Naïve Melanoma Participants
Part B: Pre- and Post-dose H-scores for Individual Participants
Part C (Randomized): Overall Survival (OS)
Part C: Plasma Concentrations of Dabrafenib and Its Metabolites
Part C: Plasma Concentrations of Trametinib
Part C: Oral Clearance (CL/F) of Dabrafenib and Trametinib
Part C: Oral Volume of Distribution (V/F) of Dabrafenib and Trametinib
Part D: Cmax of Dabrafenib Metabolites
Part D: Tmax of Dabrafenib Metabolites
Part D: Area Under the Concentration-time Curve (AUC) of Dabrafenib Metabolites
Part D: Cmax Assessment of Trametinib
Part D: Tmax Assessment of Trametinib
Part D: Area Under the Concentration-time Curve Assessment of Trametinib
Part D: Number of Participants With the Best Overall Response as Assessed by the Investigator in Participants
Part D: Duration of Response as Assessed by the Investigator
Part D: Progression-free Survival (PFS) as Assessed by the Investigator
Part D: Overall Survival (OS)
Adverse events
Limitations, agreements, and source contact
Who could take part
- eligibility Criteria
- Key Inclusion Criteria: * Capable of given written informed consent, which includes compliance with the requirements and restrictions listed in the consent form. * Male or female age 18 years or greater; able to swallow and retain oral medication. * BRAF mutation positive melanoma or colorectal cancer; other BRAF mutation positive tumor types may be considered. * Measurable disease according to RECIST version 1.1. * Eastern Cooperative Oncology Group Performance Status of 0 or 1 for Parts A and B. Subjects with Eastern Cooperative Oncology Group Performance Status of 2 or less may be entered into Part C with approval of medical monitor. * Agree to contraception requirements. * Calcium phosphorus product less than 4.0mmol2/L2. * Adequate organ system function. Key Exclusion Criteria: * Currently receiving cancer therapy (chemotherapy, radiation therapy, immunotherapy, or biologic therapy). * Part A and Part B: Prior exposure to BRAF or MEK inhibitors unless approved by the GSK Medical Monitor. * Part C: Prior exposure to BRAF or MEK inhibitors. Prior anti-cancer therapy in the metastatic setting, with the exception of up to one regimen of chemotherapy and/or interleukin-2 (IL-2). * Part D: Prior exposure to BRAF inhibitors. A washout period of 6 weeks is required for ipilimumab. * Received an investigational anti-cancer drug within 4 weeks or 5 half-lives (whichever is shorter) of study drug administration--- at least 14 days must have passed between the last dose of prior investigational anti-cancer drug and the first dose of study drug. * Current use of a prohibited medication or requires any of these medications during treatment with study drug. * Current use of therapeutic warfarin. * Any major surgery, radiotherapy, or immunotherapy within the last 4 weeks. Limited radiotherapy within the last 2 weeks. * Chemotherapy regimens with delayed toxicity within the last 4 weeks. Chemotherapy regimens given continuously or on a weekly basis with limited potential for delayed toxicity within the last 2 weeks. * Unresolved toxicity greater than National Cancer Institute-Common Terminology Criteria for Adverse Events version 4 Grade 1 from previous anti-cancer therapy except alopecia. * History of retinal vein occlusion, central serous retinopathy or glaucoma. * Predisposing factors to retinal vein occlusion including uncontrolled hypertension, uncontrolled diabetes, uncontrolled hyperlipidemia, and coagulopathy. * Visible retinal pathology as assessed by ophthalmologic exam that is considered a risk factor for retinal vein occlusion or central serous retinopathy. * Intraocular pressure greater than 21mm Hg as measured by tonography. * Glaucoma diagnosed within one month prior to study Day 1. * Presence of active gastrointestinal disease or other condition that will interfere significantly with the absorption, distribution, metabolism or excretion of drugs. * Known human immunodeficiency virus, Hepatitis B or Hepatitis C infection. * Primary malignancy of the central nervous system. * Untreated or symptomatic brain metastasis, leptomeningeal disease or spinal cord compression. Subjects who are on a stable dose of corticosteroids for more than 1 month or off corticosteroids for 2 weeks can be enrolled with approval of medical monitor. Subjects are not permitted to receive enzyme-inducing anti-epileptic drugs. * Subjects with brain metastases are excluded, unless a. All known lesions must be previously treated with surgery or stereotactic radiosurgery, and- b. Brain lesion(s), if still present, must be confirmed stable (i.e. no increase in lesion size) for ≥90 days prior to first dose on study (must be documented with two consecutive MRI or CT scans using contrast), and c. Asymptomatic with no corticosteroids requirement for ≥ 30 days prior to first dose on study, and d. No enzyme-inducing anticonvulsants for ≥ 30 days prior to first dose on study. * History of alcohol or drug abuse within 6 months prior to screening. * Psychological, familial, sociological or geographical conditions that do not permit compliance with the protocol. * QTc interval greater than or equal to 480msecs. * History of acute coronary syndromes (including unstable angina), coronary angioplasty, or stenting within the past 24 weeks. * Class II, III, or IV heart failure as defined by the New York Heart Association functional classification system. * Abnormal cardiac valve morphology (subjects with minimal abnormalities can be entered on study with approval from the medical monitor. * Treatment refractory hypertension defined as a blood pressure of systolic\> 140 mmHg and/or diastolic \> 90 mm Hg which cannot be controlled by anti-hypertensive therapy * Patients with intra-cardiac defibrillators or permanent pacemakers. * Cardiac metastases * Known immediate or delayed hypersensitivity reaction or idiosyncrasy to drugs chemically related to the study drugs or excipients. * Pregnant or lactating female. * Unwillingness or inability to follow the procedures required in the protocol. * Uncontrolled diabetes, hypertension or other medical conditions that may interfere with assessment of toxicity. * Subjects with known glucose 6 phosphate dehydrogenase deficiency.
- healthy Volunteers
- false
- minimum Age
- 18 Years
- sex
- ALL
- std Ages
- ADULT
- OLDER_ADULT
Treatment arms and interventions
- arm Groups
- description
- Day 1: GSK2118436 75mg; Day 2 through Day 16: GSK1120212 2mg; Day 15: GSK2118436 75mg +GSK1120212 2mg Drug-drug interaction
- intervention Names
- Drug: GSK2118436
- Drug: GSK1120212
- label
- Arm Part A
- type
- EXPERIMENTAL
- description
- GSK2118436 + GSK1120212 Dose escalation to a maximum tolerated combination dose
- intervention Names
- Drug: GSK2118436
- label
- Arm Part B
- type
- EXPERIMENTAL
- description
- GSK2118436 + GSK1120212 cohort expansion for safety and efficacy
- intervention Names
- Drug: GSK2118436
- Drug: GSK1120212
- label
- Arm Part C
- type
- EXPERIMENTAL
- interventions
- arm Group Labels
- Arm Part A
- Arm Part B
- Arm Part C
- description
- GSK2118436 is a potent and selective inhibitor of BRAF kinase activity with a mode of action consistent with adenosine triphosphate-competitive inhibition.
- name
- GSK2118436
- type
- DRUG
- arm Group Labels
- Arm Part A
- Arm Part C
- description
- GSK1120212 is a potent and highly selective inhibitor of MEK1/2 activation and kinase activity.
- name
- GSK1120212
- type
- DRUG
Study design
- allocation
- NON_RANDOMIZED
- masking Info
- masking
- NONE
- primary Purpose
- TREATMENT
Enrollment
- count
- 430
- type
- ACTUAL
Registered outcome plans (not posted results)
- primary Outcomes
- description
- Blood samples for PK analysis of dabrafenib and its the metabolites hydroxy-dabrafenib (GSK2285403), carboxy-dabrafenib (GSK2298683) and desmethyl-dabrafenib (GSK2167542) were obtained at pre-dose and at 1, 2, 3, 4, 6, 8, 10, and 24 hours after dabrafenib administration. From the plasma concentration-time curve, the PK parameter Cmax was determined by standard non-compartmental analysis using WinNonlin. Cmax data are reported as geometric least squares means.
- measure
- Part A: Maximum Plasma Concentration (Cmax) of a Single Dose of Dabrafenib Administered Alone and in Combination With Trametnib
- time Frame
- Day 15
- description
- Blood samples for PK analysis of dabrafenib and its metabolites hydroxy-dabrafenib (GSK2285403), carboxy-dabrafenib (GSK2298683) and desmethyl-dabrafenib (GSK2167542) were obtained at pre-dose and at 1, 2, 3, 4, 6, 8, 10, and 24 hours after dabrafenib administration. AUC is defined as the area under the dabrafenib concentration-time curve as a measure of drug exposure. AUC (0-inf) is defined as the area under the concentration-time curve from time zero (pre-dose) extrapolated to infinite time. AUC (0-t) is defined as area under the concentration-time curve from time zero (pre-dose) to the last time of quantifiable concentration. Date are reported as geometric least square means.
- measure
- Part A: AUC (0-t) and AUC (0-inf) of Dabrafenib and Its Metabolites
- time Frame
- Day 15
- description
- An AE is defined as any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a medicinal product. An SAE is defined as any untoward medical occurrence that, at any dose, results in death, is life threatening, requires hospitalization or prolongation of existing hospitalization, results in disability/incapacity, is a congenital anomaly/birth defect, or is an event of possible drug-induced liver injury.
- measure
- Part B: Number of Participants With Any Adverse Event (AE) or Serious Adverse Event (SAE)
- time Frame
- From Baseline (Day 1) until Follow-up visit (up to approximately 8 years)
- description
- Clinical Chemistry parameters were summarized according to National Cancer Institutes (NCI) Common Terminology Criteria for Adverse Events (CTCAE) grade, version 4.0. Grade 1, Mild; Grade 2, Moderate; Grade 3 (G3), Severe; Grade 4 (G4), Life-threatening or disabling; Grade 5, Death. Data are presented for only those parameters for which an increase to Grade 3 or Grade 4 occurred. Participants with missing Baseline Grade were assumed to have Baseline Grade of 0. All increases were an increase in grade from Baseline. Only descriptive analysis.
- measure
- Part B: Number of Participants With Worst-case Chemistry Toxicity Grade Change From Baseline
- time Frame
- From Baseline (Day 1) until Follow-up visit (up to approximately 8 years)
- description
- For Clinical Chemistry parameters that were not graded according to NCI CTCAE criteria, changes above (High) and below (Low) the normal range were evaluated. Participants with missing Baseline were assumed to be within normal range. Participants were counted twice if the subject "Decreased to Low" and Increase to High" during the post-baseline period. Only descriptive analysis.
- measure
- Part B: Number of Participants With Worst-case Chemistry Change From Baseline With Respect to Normal Range
- time Frame
- From Baseline (Day 1) until Follow-up visit (up to approximately 8 years)
- description
- Hematology parameters were summarized according to National Cancer Institutes (NCI) Common Terminology Criteria for Adverse Events (CTCAE) grade, version 4.0. Grade 1, Mild; Grade 2, Moderate; Grade 3 (G3), Severe; Grade 4 (G4), Life-threatening or disabling; Grade 5, Death. Data are presented for only those parameters for which an increase to Grade 3 or Grade 4 occurred. Participants with missing Baseline Grade were assumed to have Baseline Grade of 0. All increases were an increase in grade from Baseline. Only descriptive analysis.
- measure
- Part B: Number of Participants With Worst-case Hematology Toxicity Grade Change From Baseline
- time Frame
- From Baseline (Day 1) until Follow-up visit (up to approximately 8 years)
- description
- For Hematology parameters that were not graded according to NCI CTCAE criteria, changes above (High) and below (Low) the normal range were evaluated. Participants with missing Baseline were assumed to be within normal range. Participants were counted twice if the subject "Decreased to Low" and Increase to High" during the post-baseline period. Only descriptive analysis.
- measure
- Part B: Number of Participants With Worst-case Hematology Change From Baseline With Respect to Normal Range
- time Frame
- From Baseline (Day 1) until Follow-up visit (up to approximately 8 years)
- description
- Blood pressure and heart rate were summarized according to NCI CTCAE grade, version 4.0. Grade 1, Mild; Grade 2, Moderate; Grade 3 (G3), Severe; Grade 4 (G4), Life-threatening or disabling; Grade 5, Death. Data are presented for only those parameters for which an increase to G3 or G4 occurred. Blood pressure measurement included systolic blood pressure (SBP, millimeters of mercury \[mmHg\]) and diastolic BP (DBP). Heart rate is the measure of heart beats per minute (bpm). Changes in heart rate, either decrease to \<60 bpm, change to normal or no change, or increase to \>100 bpm are presented.
- measure
- Part B: Number of Participants With the Indicated Worst-case Change From Baseline in Heart Rate and Blood Pressure
- time Frame
- From Baseline (Day 1) until Follow-up visit (up to approximately 8 years)
- description
- Best overall response is defined as complete response (CR: the disappearance of all target lesions. Any pathological lymph nodes must be \<10 millimeters \[mm\] in the short axis.) or partial reponse (PR: at least a 30% decrease in the sum of the diameters of target lesions, taking as a reference, the Baseline sum of the diameters \[e.g., percent change from Baseline\]). Participants with unknown or missing responses were considered as non-responders. To be assigned a status of PR or CR, a confirmatory disease assessment should have been performed no less than 28 days after the criteria for response were first met. Response was evaluated by an investigator as per Response Evaluation Criteria in Solid Tumors (RECIST), version 1.1.
- measure
- Part C (Randomized): Number of Participants With BRAF Mutant Metastatic Melanoma With Best Overall Response as Assessed by the Investigator
- time Frame
- From the first dose of study medication to the first documented evidence of a confirmed complete response or partial response (up to approximately 7 years)
- description
- Best overall response is defined as complete response (CR: the disappearance of all target lesions. Any pathological lymph nodes must be \<10 mm in the short axis.) or partial reponse (PR: at least a 30% decrease in the sum of the diameters of target lesions, taking as a reference, the Baseline sum of the diameters \[e.g., percent change from Baseline\]). Participants with unknown or missing responses were considered as non-responders. To be assigned a status of PR or CR, a confirmatory disease assessment should have been performed no less than 28 days after the criteria for response were first met. Response was evaluated by BICR as per RECIST, version 1.1.
- measure
- Part C (Randomized): Number of Participants With BRAF Mutant Metastatic Melanoma With Best Overall Response Assessed by Blinded Independent Central Review (BICR)
- time Frame
- From the first dose of study medication to the first documented evidence of a confirmed complete response or partial response (up to approximately 19 months)
- description
- Best overall response is defined as complete response (CR: the disappearance of all target lesions. Any pathological lymph nodes must be \<10 mm in the short axis.) or partial reponse (PR: at least a 30% decrease in the sum of the diameters of target lesions, taking as a reference, the Baseline sum of the diameters \[e.g., percent change from Baseline\]). Participants with unknown or missing responses were considered as non-responders. To be assigned a status of PR or CR, a confirmatory disease assessment should have been performed no less than 28 days after the criteria for response were first met. Response was evaluated by an investigator as per RECIST, version 1.1.
- measure
- Part C (Crossover): Number of Participants With BRAF Mutant Metastatic Melanoma With Best Overall Response as Assessed by the Investigator
- time Frame
- From the first dose of study medication to the first documented evidence of a confirmed complete response or partial response (up to approximately 7 years)
- description
- PFS is defined as the interval between the date of randomization and the earliest date of PD or death due to any cause. PD was based on radiographic or photographic evidence, and assessments were made by the investigator according to RECIST, version 1.1. PD is defined as at least a 20% increase in the sum of the diameters of target lesions, taking as a reference, the smallest sum of diameters recorded since the treatment started (e.g., percent change from nadir, where nadir is defined as the smallest sum of diameters recorded since treatment start). In addition, the sum must have an absolute increase from nadir of 5 mm. Participants who received anti-cancer therapy prior to the date of documented events, were censored at the last adequate assessment prior to the initiation of therapy. If the participant did not had a documented date of events, PFS and survival were censored at the date of the last adequate assessment.
- measure
- Part C (Randomized): Progression-free Survival (PFS) as Assessed by the Investigator
- time Frame
- From the date of randomization to the earliest date of disease progression (PD) or death due to any cause (up to approximately 7 years)
- secondary Outcomes
- description
- The steady state plasma concentration (Css) of trametinib with concomitant dabrafenib administration was assessed at Day 15 and Day 16. At steady state the amount of drug administered (in a given time period) is equal to the amount of drug eliminated.
- measure
- Part A: Steady State Concentration of Trametinib With Concomitant Administration of Dabrafenib
- time Frame
- Day 15 and Day 16
- description
- Area under the concentration-time curve from time zero (predose) until the last time of quantifiable concentration (AUC \[0-tau\]) was assessed. Blood samples for PK analysis of dabrafenib and its the metabolites hydroxy-dabrafenib (GSK2285403), carboxy-dabrafenib (GSK2298683) and desmethyl-dabrafenib (GSK2167542) were obtained at Day 15 pre-dose and Day 21 pre-dose and at 1, 2, 4, 6, and 8 hours post-dose administration.
- measure
- Part B: AUC [0-tau] of Dabrafenib (DAB) and Its Metabolite in Combination With Trametinib
- time Frame
- Day 15 and Day 21
- description
- Pre-dose (trough) concentration at the end of the dosing interval (Ctau) and maximum plasma concentration (Cmax) were assessed for plasma dabrafenib (DAB) following repeat dosing of DAB administered in combination with trametinib (T). The trough concentration is defined as the plasma level of a pharmaceutical product measured just before the next dose. Blood samples for PK analysis of the metabolites hydroxy-dabrafenib (GSK2285403), carboxy-dabrafenib (GSK2298683) and desmethyl-dabrafenib (GSK2167542) of dabrafenib were obtained at Day 15 pre-dose and Day 21 pre-dose and at 1, 2, 4, 6, and 8 hours post-dose administration.
- measure
- Part B: Pre-dose (Trough) Concentration at the End of the Dosing Interval (Ctau) and Maximum Plasma Concentration (Cmax) of Dabrafenib and Its Metabolite in Combination With Trametinib
- time Frame
- Day 15 and Day 21
- description
- The tmax is defined as the time of occurenceof Cmax. Tha tmax was assessed for plasma dabrafenib (DAB) following repeat dosing of dabrafenib 75 and 150 mg BID administered in combination with trametinib. Blood samples for PK analysis of the metabolites hydroxy-dabrafenib (GSK2285403), carboxy-dabrafenib (GSK2298683) and desmethyl-dabrafenib (GSK2167542) of dabrafenib were obtained at Day 15 pre-dose and Day 21 pre-dose and at 1, 2, 4, 6, and 8 hours post-dose administration.
- measure
- Part B: Tmax of Dabrafenib and Its Metabolite in Combination With Trametinib
- time Frame
- Day 15 and Day 21
- description
- AUC (0-tau) is defined as area under the concentration-time curve from time zero (pre-dose) to last time of quantifiable concentration. AUC (0-tau) was assessed for plasma trametinib following repeat dosing of trametinib in combination with dabrafenib. Blood samples for PK analysis of the metabolites of dabrafenib were obtained at Day 15 pre-dose and Day 21 pre-dose and at 1, 2, 4, 6, and 8 hours post-dose administration.
- measure
- Part B (Analyte=GSK1120212): AUC (0-tau) Assessment of Trametinib in Combination With Dabrafenib
- time Frame
- Day 15 and Day 21
- description
- Pre-dose (trough) concentration at the end of the dosing interval (Ctau) and maximum plasma concentration (Cmax) were assessed for plasma trametinib following repeat dosing of trametinib in combination with dabrafenib. Blood samples for PK analysis of the metabolites of dabrafenib were obtained at Day 15 pre-dose or Day 21 pre-dose and at 1, 2, 4, 6, and 8 hours post-dose administration.
- measure
- Part B (Analyte=GSK1120212): Ctau and Cmax Assessments of Trametinib in Combination With Dabrafenib
- time Frame
- Day 15 and Day 21
- description
- The tmax is defined as the time of occurrence of Cmax. The PK parameter for tmax was assessed for plasma trametinib following repeat dosing of trametinib in combination with dabrafenib. Blood samples for PK analysis of the metabolites of dabrafenib were obtained at Day 15 pre-dose or Day 21 pre-dose and at 1, 2, 4, 6, and 8 hours post-dose administration.
- measure
- Part B (Analyte=GSK1120212): Tmax Assessment of Trametinib in Combination With Dabrafenib
- time Frame
- Day 15 and Day 21
- description
- Best overall response is defined as complete response (CR: the disappearance of all target lesions. Any pathological lymph nodes must be \<10 milimeter \[mm\] in the short axis.) or partial reponse (PR: at least a 30% decrease in the sum of the diameters of target lesions, taking as a reference, the Baseline sum of the diameters \[e.g., percent change from Baseline\]). Participants with unknown or missing response were considered as non-responders. To be assigned a status of PR or CR, a confirmatory disease assessment should have been performed no less than 28 days after the criteria for response were first met. Response was evaluated by an investigator as per Response Evaluation Criteria in Solid Tumors (RECIST), version 1.1. BRAFi-naïve participants were those with BRAF-mutation-positive melanoma who had not received prior therapy with a BRAF inhibitor.
- measure
- Part B: Number of Participants With BRAFi-naïve Mutant Metastatic Melanoma With the Best Overall Response as Assessed by Investigator
- time Frame
- From the first dose of study medication to the first documented evidence of a confirmed complete response or partial response (up to approximately 8 years)
- description
- Duration of response for participants with either a CR (the disappearance of all target lesions. Any pathological lymph nodes must be \<10 mm in the short axis.) or PR (at least a 30% decrease in the sum of the diameters of target lesions, taking as a reference, the Baseline sum of the diameters \[e.g., percent change from Baseline\]) is defined as the time from the first documented evidence of a PR or CR until the first documented sign of disease progression (PD) or death due to any cause. PD is defined as at least a 20% increase in the sum of the diameters of target lesions, taking as a reference, the smallest sum of diameters recorded since the treatment started (e.g., percent change from nadir, where nadir is defined as the smallest sum of diameters recorded since treatment start). In addition, the sum must have an absolute increase from nadir of 5 mm. BRAFi-naïve participants were those with BRAF-mutation-positive melanoma who had not received prior therapy with a BRAF inhibitor.
- measure
- Part B: Duration of Response as Assessed by the Investigator in Participants With BRAFi-naïve Mutant Metastatic Melanoma
- time Frame
- First documented evidence of PR or CR until the earlier of date of disease progression or date of death due to any cause (up to approximately 8 years)
- description
- PFS is defined as the interval between the first dose of study medication and the earliest date of PD or death due to any cause. PD was based on radiographic or photographic evidence, and assessments were made by the investigator according to RECIST, version 1.1. PD is defined as at least a 20% increase in the sum of the diameters of target lesions, taking as a reference, the smallest sum of diameters recorded since the treatment started (e.g., percent change from nadir, where nadir is defined as the smallest sum of diameters recorded since treatment start). In addition, the sum must have an absolute increase from nadir of 5 mm. BRAFi-naïve were the participants with BRAF-mutation positive melanoma who had not received prior therapy with a BRAF-inhibitor..
- measure
- Part B: Progression-free Survival (PFS) as Assessed by the Investigator in Participants With BRAFi-naïve Mutant Metastatic Melanoma
- time Frame
- From the date of first dose to the earliest date of disease progression (PD) or death due to any cause (up to approximately 8 years)
- description
- OS is defined as the interval of time between the first dose of study medication until the date of death due to any cause. For the participants who did not die, overall survival was censored at the date of last contact.
- measure
- Part B: Overall Survival (OS) in BRAFi Naïve Melanoma Participants
- time Frame
- From the date of first dose until date of death due to any cause (up to approximately 8 years)
- description
- p-ERK and p-AKT, biomarkers in tumor biopsies, were assessed for participants with BRAF mutant colorectal cancer. The H-score, which is a composite score that comprises intensity and percentage of staining, is a method of assessing the amount of protein or phospho-protein present in a biopsy sample. The score is obtained by the formula: (3 \* percentage of strongly staining nuclei) + (2 \* percentage of moderately staining nuclei) + (percentage of weakly staining nuclei). The H-score ranges from 0 to 300, with a score of 0 representing the absence of any of the target protein and an H-score of 300 representing maximum staining and intensity of the target protein.
- measure
- Part B: Pre- and Post-dose H-scores for Individual Participants
- time Frame
- Screening and at disease progression (up to approximately 8 years)
Full study description
- brief Summary
- This was an open-label, dose escalation study to investigate the safety, pharmacokinetics, pharmacodynamics and clinical activity of GSK2118436 and GSK1120212 in combination. This study was designed in four parts. In Part A, the effect of repeat doses of GSK1120212 on the pharmacokinetics of single dose GSK2118436 was investigated prior to evaluating combination regimens. In Part B, the range of tolerated dose combinations was identified using a dose-escalation procedure. In Part C, different dose combinations of GSK2118436 and GSK1120212 were evaluated, based on results from the dose escalation cohorts. In Part D, the pharmacokinetics and safety of GSK2118436 administered as HPMC capsules alone and in combination with GSK1120212 was evaluated.
- detailed Description
- During Part A, a cohort of subjects received a single dose of GSK2118436 alone (Day 1) and then repeat doses of GSK1120212 for (Day 2 through Day 15). The dose regimen of GSK1120212 were continuous dosing. A second single dose of GSK2118436 was administered on Day 15 concomitantly with GSK1120212. Day 16 through Day 28 was a washout period, during which no study medication was administered. Starting on Day 29, subjects who elected to continue participation in the study were doses with GSK2118436. The dose of GSK2118436 after Day 29 might be altered based on emerging data from the first-time-in human study BRF112680. The dose might be increased to a dose level that has been completed and determined to be less than or equal to the maximum tolerated dose in that study. Part B of the study enrolled cohorts in escalating doses to identify a set of allowable doses to be expanded in Part C. Subjects were enrolled in a 3+3 cohort design, with provisional dose levels of both drugs. The decision regarding escalation to the next dose levels of GSK1120212 and GSK2118436 was further guided by a Bayesian logistic regression model. The first cohort started at low doses for both drugs. Doses up to 300 mg/day for GSK2118436 and up to 3 mg QD for GSK1120212 were studied. The starting dose might be lowered based on emerging data from other studies and from Part A. Expansion cohorts enrolled in Part C at dose levels of GSK2118436 and GSK1120212 as defined in Part B. One of the selected doses might include GSK2118436 administered as monotherapy at a tolerable dose (less than or equal to the maximum tolerated dose) determined in BRF112680. Part C was a randomized open-label Phase II portion of the study, and consisted of expansion cohorts investigating 2 to 3 dose levels of GSK2118436 and GSK1120212 dosing in combination, and GSK2118436 administered as monotherapy. Subjects were assigned to treatment arms in a randomized fashion to compare tolerability and safety. Population PK parameters, clinical activity, durability of response and safety of GSK2118436 and GSK1120212 dosed orally in combination and GSK2118436 as monotherapy were evaluated. Part D consisted of evaluation of the pharmacokinetics of GSK2118436 HPMC capsules administered as monotherapy and in combination with GSK1120212. Pharmacokinetics of GSK2118436 was assessed following a single dose on Day 1 and after repeat dosing (Day 21) and compared between combination and monotherapy. The pharmacokinetics of GSK1120212 was also be assessed. Safety, tolerability and clinical activity were evaluated in 4 dosing cohorts. These cohorts might be expanded for additional safety data. Subjects were randomized to different cohorts.
Source references
- references
- citation
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- pmid
- 23020132
- type
- BACKGROUND
- citation
- Long GV, Eroglu Z, Infante J, Patel S, Daud A, Johnson DB, Gonzalez R, Kefford R, Hamid O, Schuchter L, Cebon J, Sharfman W, McWilliams R, Sznol M, Redhu S, Gasal E, Mookerjee B, Weber J, Flaherty KT. Long-Term Outcomes in Patients With BRAF V600-Mutant Metastatic Melanoma Who Received Dabrafenib Combined With Trametinib. J Clin Oncol. 2018 Mar 1;36(7):667-673. doi: 10.1200/JCO.2017.74.1025. Epub 2017 Oct 9.
- pmid
- 28991513
- type
- DERIVED
- citation
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- pmid
- 27864013
- type
- DERIVED
- citation
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- pmid
- 26811525
- type
- DERIVED
- citation
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- pmid
- 26392102
- type
- DERIVED
- citation
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- pmid
- 26340744
- type
- DERIVED
- citation
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- pmid
- 25287827
- type
- DERIVED
- citation
- Frederick DT, Salas Fragomeni RA, Schalck A, Ferreiro-Neira I, Hoff T, Cooper ZA, Haq R, Panka DJ, Kwong LN, Davies MA, Cusack JC, Flaherty KT, Fisher DE, Mier JW, Wargo JA, Sullivan RJ. Clinical profiling of BCL-2 family members in the setting of BRAF inhibition offers a rationale for targeting de novo resistance using BH3 mimetics. PLoS One. 2014 Jul 1;9(7):e101286. doi: 10.1371/journal.pone.0101286. eCollection 2014.
- pmid
- 24983357
- type
- DERIVED
- citation
- Carlino MS, Gowrishankar K, Saunders CA, Pupo GM, Snoyman S, Zhang XD, Saw R, Becker TM, Kefford RF, Long GV, Rizos H. Antiproliferative effects of continued mitogen-activated protein kinase pathway inhibition following acquired resistance to BRAF and/or MEK inhibition in melanoma. Mol Cancer Ther. 2013 Jul;12(7):1332-42. doi: 10.1158/1535-7163.MCT-13-0011. Epub 2013 May 3.
- pmid
- 23645591
- type
- DERIVED
Source notices and limitations
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- 5.4">4</a>]</li></ul></div> <p id="_289" tabindex="-1">The approval was also supported by results from <a href="/clinicaltrials/NCT01072175">COMBI-d</a> (NCT01072175), <a href="/clinicaltrials/NCT01597908">COMBI-v</a> (NCT01597908), and <a href="/clinicaltrials/NCT01336634">BRF113928</a> (NCT01336634).[<a href="#cit/section
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- Updated: February 12, 2025
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- February 12, 2025
Preserved source evidence · Independent clinical review pending · Not medical advice
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